Duration of colonization with methicillin-resistant Staphylococcus aureus among patients in the intensive care unit: implications for intervention

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Glenn RidenourMichael W Climo

Abstract

To determine the duration of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection before entry and during hospitalization in the intensive care unit (ICU) and the characteristics of patients who tested positive for MRSA. Prospective observational cohort survey. A combined medical and coronary care ICU with 16 single-bed rooms in a 427-bed tertiary care Veteran Affairs Medical Center. A total of 720 ICU patients associated with 845 ICU admissions were followed up for the detection of MRSA from January 13, 2003, to October 12, 2003. MRSA colonization was detected in patients by using active surveillance cultures (ASCs) of nasal swab specimens obtained within 48 hours of ICU entry and 3 times weekly thereafter. The duration of colonization during ICU stay and before ICU entry was calculated after a review of surveillance culture results, clinical culture results, and medical history. Ninety-three (11.0%) of 845 ICU admissions involved patients who were colonized with MRSA at the time of ICU entry, and 21 admissions (2.5%) involved patients who acquired MRSA during ICU stay. ASCs were positive for MRSA in 84 (73.6%) of the 114 admissions associated with MRSA positivity and were the sole means of identifying ...Continue Reading

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